Porous medical implant devices, particularly of metallic, ceramic or polymeric construction, but also those of biological origin, have proven of great value as scaffolds for tissue growth in medical applications. Such constructs find particular utility as scaffolds for bone growth, where the porous structure allows the prosthetic device to bind with adjacent bone as cartilage and bone grow into the pores of the device.
Many techniques have been proposed to promote the desired tissue ingrowth, including the incorporation of molecules that stimulate tissue growth, such as growth factor proteins, into the pores of the prosthetic device prior to implantation of the device in the patient. These techniques typically involve surface coating, adsorption onto a metallic surface, conjugation to a polymer surface or void-filling with biodegradable materials. Plastics such as PLA and PEG find particular use in these void-filling applications, although the degradation products of these materials in any significant quantity can impair biological function. Fibrin, collagen and bone-based cements have also been used in these void-filling applications. Other techniques for immobilizing bioactive materials in the porous structure utilizing various types of coatings have also been proposed.
The many examples in the art where therapeutic and/or bioactive materials are incorporated into medical devices are often focused on the use of a limited number of predetermined types of bioactive molecules, such as specific growth factors, which have been produced in a sterile production environment, often by recombinant techniques. Such coating systems are often better suited to a manufacturing environment than a surgical operating room. Additionally, growth factors and other therapeutic materials are found to have complex interactions with each other, all of which are not clearly understood even by those skilled in the art. While selected growth factors introduced from synthetic production have proven to have benefit, they are costly to produce and can provide adverse reactions in the patient. In addition, the selected mix of components may not have the range of therapeutic activities that may be present in endogenous tissues and fluids, such as bone marrow and adipose tissue. Because of this, in certain procedures, surgeons will often extract tissues or fluids from a patient, put it through a separation process, such as centrifugation, select a fraction which is known to be rich in desired materials, such as growth factors, stem cells or progenitor cells, and then re-inject that material into the patient at a point of injury or surgical intervention to promote healing. The present invention is directed towards the capture and utilization of bioactive molecules and biological cells as might be present in a patient's own tissues and fluids, though the novel constructs of the present invention are also compatible with the use of synthetically produced bioactive molecules and biological cells harvested from cell cultures.
Bone marrow for clinical use is typically obtained as an aspirate extracted from a target patient's bone using a syringe-type device. Often the iliac crest, pelvis or pelvic bone is used as a source due to its large size and proximity to the surface of the body. In some applications, the bone marrow is used without modification, but in many cases some form of separation technology, such as centrifugation, is used to concentrate the desired fraction of the bone marrow. Stem cells and bioactive molecules, including cytokines such as growth factors, are often the target of this separation process, though separation through centrifugation tends to select a fraction that also contains a high level of white blood cells and a broad spectrum of molecular components. Cells and molecules of interest can also typically be obtained from adipose, also fat, tissue. Any tissue of the body has potential, muscle and nerve tissue and tissues associated with the reproductive process are also of particular interest. Material extracted from the patient or intended recipient (i.e., autologous transplant material) has several advantages over other sources, including inherent biocompatibility, potential for lower cost, providing a broader spectrum of useful compounds that might have synergistic effects and potentially reduced regulatory issues or faster regulatory approval. When bone marrow derivatives are used in surgery, they are typically reintroduced into the body by injection by syringe into an area of desired activity or into an implant device or scaffold material which is then implanted in the body.
Many of the current techniques of immobilizing bioactive materials on medical devices, such as prosthetic bone implants, are not well-suited to allowing surgical teams to exercise an option to use endogenous bioactive materials. A construct which allows the surgical team to remove bone marrow from the patient and concentrate and immobilize selected bioactive components of such in the device provides advantages in genetic compatibility of the material as well as potentially reduced cost. The key challenges in such a system are the incorporation of a mostly liquid material into a highly porous material and the retention there while the device is being handled and implanted in the patient.
Thus, the present invention addresses a need in the art, providing for the capture and delivery of bioactive molecules and particularly the real-time utilization of extracted tissues and fluid, whether from the intended recipient (i.e., autologous transplant materials) or a selected donor organism (i.e., allogenic, homologous or heterologous transplant materials), as well as materials that are synthetically produced or produced from cell cultures (recombinant transplant materials). In particular, embodiments of the medical device constructs, kits and packaging systems of the present invention have unique and valuable advantages over current art and enable new medical techniques, with particular importance in surgical procedures.